Unknown Individual – Internal Medicine Physician, NPI 1235309840

Unknown Individual is a healthcare provider. based in Beaumont, Texas. specializing in Internal Medicine Physician. They hold a License No. N8154 (TX). The NPI Number for Unknown Individual is 1235309840

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1235309840
Phone
(409) 840-9300
Address
5755 COLLEGE ST
Deactivation Date
30 October 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:0State licenses:3Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 5755, College Street, Amelia, Beaumont, Jefferson County, Texas, 77707, United States

    BEAUMONT, TX 777073518

    Phone: (409) 840-9300

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77707)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1235309840 — is the standard way to identify this listing.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Beaumont, Texas in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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